Prenatal drug exposure is known to cause a variety of neurodevelopmental disorders, yet many drug-exposed neonates go undetected in the newborn nursery. Consequently, valuable intervention for the affected child is often delayed or neglected. Early identification, tracking and intervention are important in achieving a favorable outcome. The brainstem auditory evoked potential (BAEP), which is both a measure of brain maturity and integrity and a measure of sensory (auditory) function, has already gained wide acceptance as a simple, objective and non-invasive screening test for neonates at risk for auditory and neurodevelopmental disorders resulting from certain perinatal complications (e.g., low birth weight, perinatal hypoxia, low Apgar scores, craniofacial anomalies). We will apply this technology, in combination with antenatal maternal interviews, for the screening of neonates prenatally exposed to drugs. Auditory, language and neurodevelopment follow-up evaluations will be conducted at 12-months of age. The relationship between the neonatal BAEP and subsequent outcome will determine if the BAEP is a useful screening tool, leading to the early identification and intervention of drug-exposed infants with neurodevelopmental disorders. The subject population will be primarily the hard-to-reach, low-income, inner-city minority (African American) women and their infants. This project will focus on the effects of maternal alcohol, cocaine, and cigarette consumption because they are the most commonly abused drugs and because of their negative influence on the child's subsequent hearing, language and intelligence. While these drugs are frequently used in combination, little has been done in the human literature to evaluate the independent, interactive and dose-dependent effects of these drugs. This proposal will address these issues as well. Potentially confounding variables will be gathered and their influence assessed and statistically controlled. Appropriate clinical interventions for mother and infant will be made.